Q I am a 27-year-old male and in perfect health. My lips are ugly, dry, chapped and black throughout the year. I don’t smoke. Despite using lots of vaselines and balm, my lips stay the same. Please suggest the name of a good lips protector and what causes chapped and dark lips?
A Chapping of the lips is a reaction to adverse environmental conditions. It is usually caused by exposure to freezing cold and to hot, dry winds but acute sunburn can cause very similar changes. The Keratin of the lower lip margin looses its plasticity, so that the lips become sore, cracked and scaly. The affected subject tends to lick the lips or to prick at the scales, which may make the condition worse.
The treatment is by the application of emollients and the avoidance of the causative environmental conditions. Polyfax eye ointment can be applied twice daily on the affected lips.
Dr Yasmina Khan
Liaquat National Hospital
Q My wife is six months pregnant. The doctor has told her that our baby has a hole in the heart. Is this common? What is the defect called? Please tell me all you can.
A hole in the heart is a birth defect in the wall (technically called the septum) that separates the two sides of the heart (i.e., the right and left sides). This defect can be located in the septum separating the top chambers (and is called an atrial septal defect) or the lower chambers (in which case it is called a ventricular septal defect). The most common ‘hole’ in the heart is the atrial septal defect.
Treatment options vary depending on the size of the defect and the effect it is having on the circulatory system. These include a wait-and-watch approach (anticipating that the defect would close itself over time) or closure of the defect via open heart surgery or a procedure known as ‘percutaneous’ closure by inserting a tube into one of the big veins in the leg that go up to the heart and deliver a device that seals the hole. Only a paediatric cardiologist (cardiologists specializing in heart problems of children) can make the decision as to which treatment is appropriate for an individual child.
It is essential to remember that children born with such defects are (for the most part) curable if the right steps are taken at the right time. On the other hand, unnecessary delay in treatment can have serious consequences. For this reason it is very important that they be taken care of by paediatric cardiologists and not family physicians, general paediatricians (child specialists) or even adult cardiologists.
Fahim H. Jafary
Aga Khan University
Hospital
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